| NPI | 1063835288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 5646) |
| Additional Taxonomies | 363LG0600X Nurse Practitioner, Gerontology (Licence: WI 5646) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 5646) | |
| Enumeration Date | 2014-01-23 |
| Last Update Date | 2026-01-15 |